Importance of Serum Selenium Levels in Acute Heart Failure

The role of micronutrients such as selenium is linked to the different types of cardiomyopathies. Given the paradoxes and limitations of previous studies, we designed a descriptive-analytic study with a greater sample size and more variables in Iran.  

Fifty-five patients suffering from heart failure (HF) with glomerular filtration rates of 60 mL/min or higher were selected. At the onset of admission, the serum levels of selenium, proBNP, magnesium, calcium, potassium, and iron, as well as the variable of estimating prognosis (ie, 5 years’ survival based on the Seattle Heart Failure Model calculator), and also a history of diabetes mellitus, hypertension, cerebrovascular accidents, cigarette use, atrial fibrillation, and previous admissions for HF, were registered. Three months later, the New York Heart Association (NYHA) functional class, the left ventricular ejection fraction, and the proBNP level were rechecked.  

Selenium deficiency (≤ 45µg/L) was detected in 25.4% of the patients. The mean serum level of selenium was 62 ± 24.9 µg/L, and it had no significant relationship with etiology; prognosis; the left ventricular ejection fraction; the proBNP level; the NYHA functional class; the dose of furosemide before admission; the consumption of angiotensin-converting-enzyme inhibitors/angiotensin II receptor blockers, beta-blockers, statins, and allopurinol; laboratory variables; age; sex; diabetes mellitus; hypertension; cerebrovascular accidents; atrial fibrillation; and cigarette use. Nonetheless, the mean serum level of selenium had significant reversed relationships with previous admissions for HF and potassium-sparing diuretic use (P = 0.012 and P = 0.026, respectively) (confidence interval = 95%).  

The prevalence of selenium deficiency in our patients with HF was considerable. The mean serum level of selenium was similar in both ischemic and nonischemic groups; nevertheless, the level had no significant relationship with the majority of clinical and paraclinical variables of HF severity and prognosis. Future studies should investigate the relationship between the serum level of selenium and the precise cumulative dose of diuretics at the end of the admission process and the interaction between selenium and mineralocorticoid receptors.(Iranian Heart Journal 2020; 21(3): 118-127)